Fluorine is a very active and dangerous gaseous element that is almost never found in elemental form but almost always in combination with other elements, producing fluoride compounds. Chemical compounds of fluoride occur naturally in the environment and they commonly are associated with weathering or the erosion of rock and soil. Fluorides get into the environment through the dissolution of fluoride minerals as groundwater moves through an aquifer and by volcanic emissions. Organic fluorides can be found in vegetables, fruits, and nuts. Fluoride can be accidentally released to the environment through a combination of man-made or related activities, such as: mining, manufacturing aluminum, manufacturing of glass and steel, rodent poisons, and processing phosphate ores. Fluoride is also intentionally added to some city water systems to prevent tooth decay (it hardens the enamel of the teeth).
Concentrations above 5 mg/l are detrimental to the structure of the tooth and can be associated with dental fluorosis, i.e., mottled or discolored teeth.
Skeletal fluorosis is a bone disease caused by excessive accumulation of fluoride in the bones. In advanced cases, skeletal fluorosis causes painful damage to bones and joints. Dental fluorosis is mottled or discolored teeth. Fluoride can also damage the parathyroid gland hyperparathyroidism, which ultimately results in the loss of calcium from the bone. Fluoride overexposure, depending on the exposure route, can be associated with respiratory problems, stomach pains, and neurological problems.
The EPA has set a primary maximum contaminant level for fluoride of 4 mg/L and a secondary maximum contaminant level of 2.0 mg/L. Canada, Hong Kong, and the WHO have a standard of 1.5 mg/L.
Like many contaminants in drinking water, this element is potentially hazardous at levels or concentrations that do not impart a noticeable taste, odor, or appearance to the water. Your best course of action is to get your water tested and compile as much information as possible about your water supply source, well construction, surrounding land-use, and local geology. If you do have a fluoride problem, there are water treatment technologies available now that can reduce or even remove fluoride from your drinking water. On the question: Should Water Systems add fluoride? "We encourage proper dental care by a parent under the care of a licensed dentist", rather than the addition of fluoride to drinking water.
To the best of our knowledge between 2015 and 2017, elevated levels of fluoride, > 4 mg/L, have been detected in 14 states (Source).
Level 1 Testing is done with simple observations that an individual can make with their own senses such as sight, smell, and taste. These observations can be readily apparent or can be observed as they change over time. In addition, accessible related information about the home can also be used to narrow down the cause of your water issues.
The symptoms for fluoride in the water include:
Level 2 Testing is Do-It-Yourself testing that can be done in your own home using a Testing Kit. After you’ve done Level 1 Testing, Level 2 Testing can confirm if your observations are correct. If your test results reveal the presence of a contaminant that is cause for concern, you can either proceed to determine the best treatment (see below) or continue to Level 3 Testing.
There are not many in-home screening tests for fluoride, but Test Lab makes a 15 test strip we have found useful in screening water quality. If you are interested in reading about the issues of fluoride in drinking water, we recommend the book "The Case Against Fluoride".
<div class="product-note in-L4-carbon-filtration">Note: For rural Areas with <a href="/indoor-6/herbicides-pesticides">Herbicides and Pesticides</a> Usage</div>
<div class="product-note in-L4-sulfur-treatment">Note: Use in combination with Sulfate-Reducing Bacteria Test</div>
<div class="product-note in-L6-bromate">Note: If the concentration is < 0.01 mg/L</div>
<div class="product-note in-L6-uranium">Note: Uranium less than < 0.030 mg/L</div>
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<div class="product-note in-L4-sulfur-treatment">Note: Use in combination with Sulfate-Reducing Bacteria Test</div>
<div class="product-note in-L6-bromate">Note: If the concentration is < 0.01 mg/L</div>
<div class="product-note in-L6-uranium">Note: Uranium less than < 0.030 mg/L</div>
Level 3 Testing is done through an accredited Water Testing Laboratory. With Level 3 Testing, you can order a testing kit that is used to prepare your sample and submit it to the lab. By utilizing a lab, you have the assurance that a certified water expert had analyzed your water sample. If your test results reveal the presence of a contaminant that is cause for concern, you can either proceed to determine the best treatment options (see below) or continue to Level 4 Testing - Certified Testing.
Most high quality informational water testing kits include testing for fluoride. If you are on a private water source, we would recommend the National Testing Laboratory - Well Water Check Deluxe, but if you are in an area with significant mining, industrialization, or petrochemical development we would recommend the Tap Score Extended Well Water Test. If you are a city water user, we recommend the National Testing Laboratory City Water Check Deluxe. If you are on a fixed budget, you may want to consider the single parameter fluoride test.
<div class="product-note in-L4-carbon-filtration">Note: For rural Areas with <a href="/indoor-6/herbicides-pesticides">Herbicides and Pesticides</a> Usage</div>
<div class="product-note in-L4-sulfur-treatment">Note: Use in combination with Sulfate-Reducing Bacteria Test</div>
<div class="product-note in-L6-bromate">Note: If the concentration is < 0.01 mg/L</div>
<div class="product-note in-L6-uranium">Note: Uranium less than < 0.030 mg/L</div>
A Level 4 Certified Test Test uses chain-of-custody with a water professional coming to your home to prepare the water sample and then works with an accredited laboratory in order to certify your test results. This type of testing not only gives you the highest level of assurance in the accuracy of your test results, but can also be used as a document in legal cases. For Baseline Testing, we recommend that you use Certified Testing.
If after the screening testing and diagnostic analysis, the available information suggests a problem with fluoride, we would recommend city water customers get a copy of their Consumer Confidence Report and for private water users to have a Neighborhood Hazard Survey completed. This information can then be used to develop a recommendation for the extent, type, and nature of the certified testing that is needed.
Pretreatment may be needed in some cases to ensure acceptable treatment by the primary water treatment system. Some of the treatment technologies may not be amenable to point-of-entry or even whole-house treatment options. In these cases, point-of-use units may be the best option. Periodic testing should be maintained after the treatment system is in place to ensure objectives are being met and the system is operating properly and most systems will require maintenance on at least an annual basis.
If it appears you are experiencing a problem with fluoride, do not boil your drinking water. An interim solution may be the use of a point-of-use device or using a bottled water source. Because other contaminants may be present in the water, it would be advisable to have the water tested before and after the use of any point-of-use device.
<div class="product-note in-L4-carbon-filtration">Note: For rural Areas with <a href="/indoor-6/herbicides-pesticides">Herbicides and Pesticides</a> Usage</div>
<div class="product-note in-L4-sulfur-treatment">Note: Use in combination with Sulfate-Reducing Bacteria Test</div>
<div class="product-note in-L6-bromate">Note: If the concentration is < 0.01 mg/L</div>
<div class="product-note in-L6-uranium">Note: Uranium less than < 0.030 mg/L</div>
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For the long-term, it may be necessary to install a water treatment system. For fluoride, the common water treatment technologies are ion-exchange, reverse osmosis, and distillation. Depending on the technology and the concentration of fluoride and other contaminants, the system may require a number of treatment approaches and a combination of a whole-house treatment system and then point-of-use treatment devices. Regarding dental health, we strongly suggest that you seek guidance from a licensed dentist.
<div class="product-note in-L4-carbon-filtration">Note: For rural Areas with <a href="/indoor-6/herbicides-pesticides">Herbicides and Pesticides</a> Usage</div>
<div class="product-note in-L4-sulfur-treatment">Note: Use in combination with Sulfate-Reducing Bacteria Test</div>
<div class="product-note in-L6-bromate">Note: If the concentration is < 0.01 mg/L</div>
<div class="product-note in-L6-uranium">Note: Uranium less than < 0.030 mg/L</div>
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